The Washington University School of Medicine will collaborate with the health departments of St. Louis to achieve the major objectives of this application: 1) To develop a coordinated, longitudinal tuberculosis (TB) curriculum intended to provide appropriate competencies, through traditional means, self-assessment strategies, training practicums and OSCE's, in the principles of tuberculosis prevention, management and control for medical students, residents, fellows and faculty in infectious diseases and pulmonary medicine, and infection control and public health nurses. 2) To convene a voluntary multidisciplinary advisory panel whose mission will be to designate core TB care processes as targets for educational initiatives and process improvement. Statistical process control methodology will be used assess the current state of these core processes, monitor the impact of educational initiatives, and other process improvement efforts, and give structured feedback regarding these processes to institutions and practitioners caring for TB patients. 3) To develop a targeted educational program for health professionals and institutions who care for the majority of patients with TB in St. Louis, furnishes information regarding the national, state, and local epidemiology of TB, and strongly emphasizes the need to coordinate the care of the TB patient with input from the public health departments, particularly in bridging the transition from inpatient to outpatient care, using appropriate medical regiments administered by directly observed therapy (DOT), the use of isoniazid preventive therapy, including directly observed preventive therapy (DOPT) when appropriate, and appropriate monitoring for therapeutic response and toxicities. This project will serve to coordinate and improve the quality of the TB curriculum, provide innovative instruction for physicians-in-training and practitioners who care for patients with TB or persons at risk for TB, and develop and test a model which will provide a portable framework for interaction of public and private health institutions.